Aortic Dissection – A cardiac condition that demands immediate intervention

Aorta is the blood vessel which carries blood to the entire body from the heart. Aortic dissection is a disease wherein there is partial disruption of the wall of the aorta. This disease has a very high risk of complete disruption of the aortic wall leading to exsanguinating hemorrhage causing instantaneous death.

Aortic dissection occurs more frequently in patients with connective tissue disorder (e.g. Marfan syndrome) and those with uncontrolled hypertension. The primary symptom is a sudden onset of excruciating chest pain which may radiate to neck or back. It can be accompanied with sudden breathing difficulty, loss of consciousness, profuse sweating or severe abdominal pain. Clinically it resembles a heart attack, but a clinician can differentiate between them. Though echocardiography helps in establishing the diagnosis, a computed tomography (CT) scan is needed to confirm the diagnosis and establish the extent of the disease. Aortic dissection requires urgent surgical intervention as the risk of complete disruption of the aorta with each heartbeat is very high.

In most of the cases, along with the disruption of the aortic wall, there is disruption of the heart valve, which guards the entry of blood from the heart into the aorta, as well. Therefore, in the surgical treatment complete replacement of the aortic valve as well as the aorta is needed and it is called the Bentall procedure. It is a complex cardiac surgery and only a few centres in our country specialize in the procedure.

Results of a prompt surgical intervention are very promising. After a successful Bentall procedure, patients gradually recover, come back to their normal life and start leading a complete and productive life. Timely detection and treatment are the keys to survival when it comes to the life-threatening aortic dissection.

 The writer, Dr. Rachit Saxena is a Senior Consultant Cardiac and Aortic Surgery at Narayana Superspeciality Hospital in Gurugram

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